Gabapentin (Neurontin)

[Nick47]

What conclusion do you draw from Gabapentin in your case so far?

It lowers the intensity of my tinnitus.

 

[Kleiner]

It lowers the intensity of my tinnitus.

It's a very vague answer. Anyway, happy for you.

 

[Nick47]

It's a very vague answer. Anyway, happy for you.

Well, what do you want me to say? Gabapentin lowers my tinnitus by around 30-50% I would say.

 

[kingsfan]

You scale at microdoses guys, I find it hard to see how such a low dose can have any effect, I hope it's not a placebo.

What exactly was your intention with this statement?

 

[Kleiner]

Well, what do you want me to say? Gabapentin lowers my tinnitus by around 30-50% I would say.

Well, is it temporarily? Does this concern all tinnitus or just one tone? What is the dosage/effectiveness ratio? That kind of stuff, but don't feel you have to answer

What exactly was your intention with this statement?

That this dose is, according to what I know, below the threshold of effectiveness for this drug, so I'm curious how you can get relief with such a small amount.

 

[Nick47]

Well, is it temporarily? Does this concern all tinnitus or just one tone? What is the dosage/effectiveness ratio? That kind of stuff, but don't feel you have to answer

Yes, temporarily, although it seems to settle my tinnitus for a few days after stopping. Dosage low, around 400-600 mg/day.

Erm, I've got multiple tones, which I've never counted or measured as it's pointless.

 

[kingsfan]

That this dose is, according to what I know, below the threshold of effectiveness for this drug, so I'm curious how you can get relief with such a small amount.

Maybe its effectiveness for epilepsy, but that ain't what I got, ya know?

Anyway, my tinnitus is louder when I take it, but less intense after it wears off. So it's not about the effectiveness of the drug, but whatever is happening physiologically after its half life expires.

 

[grate_biff]

I just sent Biohaven an e-mail, asking about tinnitus and hyperacusis.

Well done.

No answer from Biohaven

 

[lapidus]

@Nick47, I know you ran out of Gabapentin but did you manage to get a new prescription? You're writing about it as if you're currently on it so I figure you did? You mentioned in another thread that it reduced the reactivity of your tinnitus. Do you mean that it reduced the reactivity permanently or only as long as the effect of the drug lasts?

 

[Nick47]

know you ran out of Gabapentin but did you manage to get a new prescription? You're writing about it as if you're currently on it so I figure you did? You mentioned in another thread that it reduced the reactivity of your tinnitus. Do you mean that it reduced the reactivity permanently or only as long as the effect of the drug lasts?

I've ordered more online as my GP refused. Fuck them. So I have currently none to trial. It reduced my tinnitus, period, and quite a bit.

It's a treatment, not a cure, hence, stop the treatment and the condition gets worse again. Apart from brain implants, I think this is and will be the case for most tinnitus treatments. And many other disorders i.e. heart disease, diabetes, epilepsy etc. They have treatments, not cures!

Below is from the 2017 study on acoustic trauma patients. Double-blind and randomised, placebo-controlled. I'd say that's a whopping great drop. Even above placebo, which is also a big drop. Funny how we are when it comes to placebo.

58% taking placebo improved versus 89% taking Gabapentin.

 

[AfroSnowman]

I've ordered more online as my GP refused. Fuck them. So I have currently none to trial. It reduced my tinnitus, period, and quite a bit.

It's a treatment, not a cure, hence, stop the treatment and the condition gets worse again. Apart from brain implants, I think this is and will be the case for most tinnitus treatments. And many other disorders i.e. heart disease, diabetes, epilepsy etc. They have treatments, not cures!

Below is from the 2017 study on acoustic trauma patients. Double-blind and randomised, placebo-controlled. I'd say that's a whopping great drop. Even above placebo, which is also a big drop. Funny how we are when it comes to placebo.

58% taking placebo improved versus 89% taking Gabapentin.

View attachment 55387

I tried Gabapentin a little bit without any relief. How much did you take and how quickly did you experience relief?

 

[Nick47]

How much did you take and how quickly did you experience relief?

In a day or so. 300 mg x 2. Hit and miss but some relief.

 

[AfroSnowman]

In a day or so. 300 mg x 2. Hit and miss but some relief.

Didn't do it twice a day but worked my way up to 600 mg x 1 at night. Super frustrating that nothing makes any difference.

 

[Nick47]

Didn't do it twice a day but worked my way up to 600 mg x 1 at night. Super frustrating that nothing makes any difference.

Do you get no temporary relief from anything else besides Gabapentin?

Alprazolam, Clonazepam, Cyclobenzaprine?

 

[AfroSnowman]

Do you get no temporary relief from anything else besides Gabapentin?

Alprazolam, Clonazepam, Cyclobenzaprine?

Gabapentin doesn't do anything for me either. Haven't tried cyclobenzaprine. As to the rest of them, you know they probably chill out my reaction to the noise a bit, but not in a way that makes any meaningful difference above the relief coming from the empowerment of doing something in the face of this endless condition. They certainly don't have any impact on volume or intrusiveness.

 

[kingsfan]

Didn't do it twice a day but worked my way up to 600 mg x 1 at night. Super frustrating that nothing makes any difference.

Gabapentin has a really short half life, so you may want to try taking it up to 3 times a day.

300 mg / 3 times a day seems to be a common dosage schedule.

 

[Starthrower]

Interesting thread. I have been put on Gabapentin for extreme nerve pain. I noticed the 100 mg did nothing and the doctor told me to take two or 200 mg. It helped with the pain which also attributed to my noise level.

I was told it is a very safe medication without risk for addiction or such.

 

[StoneInFocus]

I'm very much of the opinion that a multifactorial approach to treatment brings the best long-term plasticity. So hearing aids, ALA, electrical stimulation, CBT and a "combination" of medicines at low doses are the way to do it. Otherwise going through each treatment on its own to see what works is tantalizing and futile.

Unfortunately, here in the UK, we are very much into unimodal outdated stuff with tinnitus. So they give hearing aids and ask if they help. Then they prescribe an SSRI and ask if it helps, and so on...

It would be like giving an HIV patient one medication and seeing if it helps, then switching to a different one. All the medications on their own only extend life by a few years, as the virus adapts to overcome the medication. Perhaps the equivalent of reaching tolerance. Some time ago they realised a "combination" of 4-5 medications works, and they live a normal life span, as the virus is not able to overcome the "combination."

Yes, I totally agree. I think the idea of a one-pill-fixes-all cure is outdated. I also think it is important to keep the practicality of taking tinnitus and hyperacusis alleviating drugs in mind.

If a certain medication lessens perceived tinnitus symptoms but its side effects are so severe that the effective life quality has remained the same, such as when it causes suicidality or severe inebriation, then what's the point of taking it?

For example, if we look at the Retigabine User Experiences thread, the evidence for it helping tinnitus and hyperacusis is actually quite sparse. Maybe it would've totally silenced tinnitus at 2 or 3 times the maximum dosage, but even if we disregard side effects unrelated to its potassium modulating properties, who knows what kind of impact that would have on the central nervous system?

Same story for Ivabradine. Maybe it could actually sufficiently alleviate tinnitus & hyperacusis symptoms, but only at doses at which severe bradycardia would occur.

With a multifactorial approach, I think you'd spread out the adverse effects over different cells and tissues, making it a more practical approach to treating these disorders.

 

[Nick47]

If a certain medication lessens perceived tinnitus symptoms but its side effects are so severe that the effective life quality has remained the same, such as when it causes suicidality or severe inebriation, then what's the point of taking it?

Yes, this is the issue. Turning one problem (tinnitus) into another equally as bad where you turn the person into a zombie.

 

[vttbx]

I use Gabapentin whenever my hyperacusis pain spikes. It always helps even in small dosages (max 3x 100 mg daily). It lowers my tinnitus only slightly.

 

[Lucifer]

I use Gabapentin whenever my hyperacusis pain spikes. It always helps even in small dosages (max 3x 100 mg daily). It lowers my tinnitus only slightly.

Do you find you can tolerate more noise with Gabapentin or does it only reduce the pain?

 

[Nick47]

I use Gabapentin whenever my hyperacusis pain spikes. It always helps even in small dosages (max 3x 100 mg daily). It lowers my tinnitus only slightly

Yes, from what I've read, the lower the dose, the higher the bioavailability. It helps my anxiety a bit too.

 

[StoneInFocus]

I use Gabapentin whenever my hyperacusis pain spikes. It always helps even in small dosages (max 3x 100 mg daily). It lowers my tinnitus only slightly.

Hey, would you be so kind as to describe your pain symptoms? Burning pain (reactive or in silence), acute/stabbing pain, etc.

Could you quantify the pain reduction? What isn't painful on Gabapentin that is painful normally?

Are you using other medication simultaneously with Gabapentin?

 

[vttbx]

Do you find you can tolerate more noise with Gabapentin or does it only reduce the pain?

It doesn't help with noise tolerance or hyperacusis. Only with the pain.

Hey, would you be so kind as to describe your pain symptoms? Burning pain (reactive or in silence), acute/stabbing pain, etc.

Could you quantify the pain reduction? What isn't painful on Gabapentin that is painful normally?

Are you using other medication simultaneously with Gabapentin?

It's an aching/burning pain that's reactive to noise. It gets my pain level to zero. No other meds. I titrate up and down. 100 mg for a few days, then 200 mg, to 300 mg, then back down.

 

[StoneInFocus]

I've never tried Gabapentin alone, but it seems to be a good combo with other antiepileptics, even if the results don't seem definitive.

Such as?

It doesn't help with noise tolerance or hyperacusis. Only with the pain.

It's an aching/burning pain that's reactive to noise. It gets my pain level to zero. No other meds. I titrate up and down. 100 mg for a few days, then 200 mg, to 300 mg, then back down.

Hey, thanks for your answer. By reactive to noise, do you mean immediate pain as the sound waves hit your ear so to speak, or pain that sets in some time after noise exposure?

 

[vttbx]

By reactive to noise, do you mean immediate pain as the sound waves hit your ear so to speak, or pain that sets in some time after noise exposure?

For me, the pain sets in over time. It's usually a few hours, but always less than 12 hours.

 

[Kleiner]

Such as?

Kv7 openers.

It's far from a miracle but it's the only thing in 3 years of tinnitus that has objectively destroyed my tinnitus temporarily.

 

[StoneInFocus]

Kv7 openers.

Could you please name the specific drugs, what doses you used and which one worked the best with Gabapentin?

 

[Kleiner]

Could you please name the specific drugs, what doses you used and which one worked the best with Gabapentin?

Well, I don't know if it fits in the charter, but Trobalt by far. I was lucky enough to get some stock from someone who kept it in a freezer.

Trobalt works, but is far from a miracle treatment since it's pretty unstable. However, the next generation Kv7 openers, in the event that their action on tinnitus generating Kv7s are similar to Retigabine, should be an effective treatment, for DCN related cases at least.

 

[Lucifer]

Well, I don't know if it fits in the charter, but Trobalt by far. I was lucky enough to get some stock from someone who kept it in a freezer.

Trobalt works, but is far from a miracle treatment since it's pretty unstable. However, the next generation Kv7 openers, in the event that their action on tinnitus generating Kv7s are similar to Retigabine, should be an effective treatment, for DCN related cases at least.

Do you suffer from hyperacusis/noxacusis? If you do, did Trobalt work for your hyperacusis/noxacusis as well?